持续和间歇声门下分泌物引流在重型颅脑创伤患者中的应用:51例患者回顾性研究

Application of continuous and intermittent subglottic secretion drainage in patients with severe traumatic brain injury:A retrospective study with 51 cases

目的探讨持续声门下分泌物引流(CSSD)和间歇声门下分泌物引流(ISSD)在重型颅脑创伤(sTBI)患者中的应用效果。方法回顾性分析51例sTBI患者应用CSSD和ISSD的效果。结果相较于CSSD组,ISSD组患者的日均引流量较少,日均呛咳次数较少,误吸发生率较高,呼吸道黏膜损伤发生率较低,机械通气时间、NICU住院时间更短,差异有统计学意义(P<0.05)。2组在呼吸机相关性肺炎(VAP)发生率和发生时间以及出院时格拉斯哥预后(GOS)评分方面差异无统计学意义(P>0.05)。结论对于sTBI患者而言,ISSD可能更优于CSSD,值得在NICU中推广应用。

Objective To investigate the effect of continuous subglottic secretion drainage(CSSD)and intermittent subglottic secretion drainage(ISSD)in patients with severe traumatic brain injury.Methods To retrospectively analyze the effects of CSSD and ISSD in 51 patients with severe traumatic brain injury.Results Compared with the CSSD patients,the ISSD patients had less daily average drainage volume and daily average coughing,a higher incidence of respiratory aspiration,a lower incidence of respiratory mucosal damage,and shorter mechanical ventilation time and NICU hospital stay(P<0.05).There was no significant difference in the incidence of ventilator-associated pneumonia(VAP),occurrence time of VAP and Glasgow Outcome Scale(GOS)before discharge from hospital between two groups(P>0.05).Conclusion For patients with severe traumatic brain injury,ISSD may be a better option than CSSD,and it is worth promoting in the NICU.